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Mortality of 1,479 Children Born in Eleven Punjab Villages,
by Interval between Observed and Preceding Child,
India, 1955-1958
Interval		Neonatal Mortality:	Infant Mortality:	Second Year
between	Number	Deaths per 1,000	Deaths per 1,000	Mortality:
Births in	of	Infants Aged Less	Population Aged	Deaths per 1,000
Months	Births	Than 28 Daysa	Less Than 1 Yearb	Population0
Primipara	231	95.2	175.4	68.7
0-11	34	88.2	205.9	105.3
12-23	432	97.2	201.9	54.9
24-35	491	57.0	132.2	89.0
36-47	175	57.1	137.9	57.7
48+	112	35.7	108.1	29.0
Unknown	4	0.0	0.0	0.0
Total	1,479	73.7	160.6	67.9
aNumber	=  1479.			
Number	= 1457.			
c Number	=    854.			
Source: Gordon et al. (63).
weaning occur earlier with the consequent weanling diarrhea so often seen in developing countries (64). The younger he is when this occurs, the more serious the consequences are likely to be.
During the period of their study the index children who could be observed for a sufficient length of time after the birth of a subsequent sibling were few in number. The authors report the following, however:
From the data which exist, the suggestion is that the effect of a short birth interval is more marked for the first child of a pair than it is for the second, as definite as that is. (63, p. 372)
Birth Interval and Morbidity. No studies of the association between acute illness and birth interval have been found. As remarked earlier, however, death is the extreme end of the spectrum of morbid processes, and the clear-cut associations between mortality rates and birth interval in the post-neonatal and l-to-4-year age groups seen above would surely lead us to expect an increase in illness among closely spaced children.
With regard to more chronic processes—malnutrition, for example-Gordon's remarks above (63) concerning the effects of interval on the preceding child are particularly relevant. It is also pertinent to note that one of the most severe forms of malnutrition seen in developing countries was called kwashiorkor by Williams when she first reported it in 1935 (65). In discussing
rhis mnnv vftars latftr (f\(\\.  she rennrtfid   that in thp. Afrirjin trihtil Innonnootion, but it seems likely that many mothers in such situations would receive less than optimal prenatal care and be subject to more emotional stress than mothers who conceive their first child after marriage.